{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T08:15:27Z","timestamp":1788336927772,"version":"build-2803163510"},"reference-count":33,"publisher":"American Academy of Pediatrics (AAP)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>To test the hypothesis that community deprivation, race, and ethnicity lead to decreased likelihood of undergoing hepatoportoenterostomy, older age at surgery, decreased likelihood of achieving successful bile drainage, and lower rates of native liver survival for infants with biliary atresia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>We analyzed a prospectively enrolled cohort of infants with biliary atresia from the Childhood Liver Disease Research Network (ChiLDReN) that reflects the demographics of the US population. We tested the association between demographic, clinical, and anatomic variables and the probability of undergoing hepatoportoenterostomy, age at surgery, success of surgical intervention, and native liver survival using linear and logistic regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Seven hundred nineteen infants with biliary atresia from 15 centers met study inclusion criteria and 672 (93.5%) underwent hepatoportoenterostomy. After adjusting for potential confounders, Asian race (odds ratio [OR]\u2009=\u20090.21, 0.06\u20130.77), Hispanic ethnicity (OR\u2009=\u20090.33, 0.14\u20130.76), and community deprivation (0.71 per 0.1 increase, 0.52\u20130.97) were independently associated with decreased probability of undergoing hepatoportoenterostomy. Each 10% increase in community deprivation increased the age at hepatoportoenterostomy by approximately two-and-one-third days (estimate 2.31; P\u2009=\u2009.48). Black\/African American infants were approximately 9\u00a0days older than white infants at the time of operation (estimate 9.19; P\u2009=\u2009.01), while age at hepatoportoenterostomy (OR\u2009=\u20090.90, P\u2009=\u2009.01) and successful bile drainage at 3\u00a0months (OR\u2009=\u200926.15, P\u2009&amp;lt;\u2009.01) were independently associated with native liver survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Community deprivation, race, and ethnicity are associated with both lower hepatoportoenterostomy rates and older age at the time of operation, whereas clinical and anatomic variables are associated with successful biliary drainage and native liver survival.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1542\/peds.2025-071520","type":"journal-article","created":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T00:02:14Z","timestamp":1771459334000},"source":"Crossref","is-referenced-by-count":1,"title":["Demographic Factors and Biliary Atresia: A Childhood Liver Disease Research Network Study"],"prefix":"10.1542","volume":"157","author":[{"given":"Zachary J.","family":"Kastenberg","sequence":"first","affiliation":[{"name":"1Department of Surgery, Division of Pediatric Surgery, Intermountain Primary Children\u2019s Hospital, University of Utah, Salt Lake City, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte A.","family":"Beil","sequence":"additional","affiliation":[{"name":"2Arbor Research Collaborative for Health, Ann Arbor, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Henn","sequence":"additional","affiliation":[{"name":"2Arbor Research Collaborative for Health, Ann Arbor, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Estella M.","family":"Alonso","sequence":"additional","affiliation":[{"name":"3Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, Ann and Robert H. Lurie Children\u2019s Hospital of Chicago, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evelyn K.","family":"Hsu","sequence":"additional","affiliation":[{"name":"4Department of Pediatrics, Division of Gastroenterology and Hepatology, Seattle Children\u2019s Hospital, University of Washington, Seattle, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kasper","family":"Wang","sequence":"additional","affiliation":[{"name":"5Hospital for Sick Children, University of Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vicky L.","family":"Ng","sequence":"additional","affiliation":[{"name":"5Hospital for Sick Children, University of Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nitika A.","family":"Gupta","sequence":"additional","affiliation":[{"name":"6Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, Children\u2019s Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John C.","family":"Magee","sequence":"additional","affiliation":[{"name":"7Department of Surgery, Section of Transplant Surgery, University of Michigan Medical School, Ann Arbor, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert M.","family":"Merion","sequence":"additional","affiliation":[{"name":"7Department of Surgery, Section of Transplant Surgery, University of Michigan Medical School, Ann Arbor, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Horslen","sequence":"additional","affiliation":[{"name":"8Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, Children\u2019s Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saul J.","family":"Karpen","sequence":"additional","affiliation":[{"name":"9Stravitz-Sanyal Institute for Metabolic Health and Liver Disease, Virginia Commonwealth University, Richmond, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rohit","family":"Kohli","sequence":"additional","affiliation":[{"name":"10Department of Pediatrics, Division of Gastroenterology, Hepatology, and Nutrition, Children\u2019s Hospital of Los Angeles, Keck School of Medicine, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen","family":"Loomes","sequence":"additional","affiliation":[{"name":"11Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, Children\u2019s Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Miethke","sequence":"additional","affiliation":[{"name":"12Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children\u2019s Hospital Medical Center, Cincinnati, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyla M.","family":"Tolliver","sequence":"additional","affiliation":[{"name":"13Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, Indiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Rosenthal","sequence":"additional","affiliation":[{"name":"14Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, University of California San Francisco; San Francisco, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjiv","family":"Harpavat","sequence":"additional","affiliation":[{"name":"15Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, Texas Children\u2019s Hospital, Baylor College of Medicine, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald J.","family":"Sokol","sequence":"additional","affiliation":[{"name":"16Department of Pediatrics, Section of Gastroenterology, Hepatology and Nutrition, Children\u2019s Hospital Colorado, University of Colorado School of Medicine, Aurora, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen L.","family":"Guthery","sequence":"additional","affiliation":[{"name":"17Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, Intermountain Primary Children\u2019s Hospital Salt Lake City, University of Utah, Salt Lake City, Utah"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2026,2,19]]},"reference":[{"issue":"6","key":"2026030411121431600_r1","doi-asserted-by":"crossref","first-page":"1209","DOI":"10.1016\/j.jhep.2013.01.040","article-title":"Improving outcomes of biliary atresia: French national series 1986\u20132009","volume":"58","author":"Chardot","year":"2013","journal-title":"J Hepatol."},{"issue":"5","key":"2026030411121431600_r2","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1053\/j.sempedsurg.2017.09.003","article-title":"Long-term outlook in biliary atresia","volume":"26","author":"Kelay","year":"2017","journal-title":"Semin Pediatr Surg."},{"issue":"6","key":"2026030411121431600_r3","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1016\/j.jpeds.2007.05.051","article-title":"Biliary atresia: the Canadian experience","volume":"151","author":"Schreiber","year":"2007","journal-title":"J 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Screen."},{"issue":"6","key":"2026030411121431600_r13","doi-asserted-by":"crossref","first-page":"e1663","DOI":"10.1542\/peds.2015-3570","article-title":"Newborn screening for biliary atresia","volume":"136","author":"Wang","year":"2015","journal-title":"Pediatrics."},{"issue":"6","key":"2026030411121431600_r14","doi-asserted-by":"crossref","first-page":"1196","DOI":"10.1016\/j.jpedsurg.2021.02.027","article-title":"Variability in age at Kasai portoenterostomy for biliary atresia across US children\u2019s hospitals","volume":"56","author":"Apfeld","year":"2021","journal-title":"J Pediatr Surg."},{"issue":"4","key":"2026030411121431600_r15","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1097\/MPG.0000000000002836","article-title":"Cholangitis in patients with biliary atresia receiving hepatoportoenterostomy: a national database study","volume":"71","author":"Cheng","year":"2020","journal-title":"J Pediatr Gastroenterol 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analysis","volume":"41","author":"Trinidad","year":"2022","journal-title":"Health Aff (Millwood)."}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/doi\/10.1542\/peds.2025-071520\/1911906\/pediatrics.2025071520.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/doi\/10.1542\/peds.2025-071520\/1911906\/pediatrics.2025071520.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T16:12:19Z","timestamp":1772640739000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/157\/3\/e2025071520\/206431\/Demographic-Factors-and-Biliary-Atresia-A"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,19]]},"references-count":33,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,2,19]]},"published-print":{"date-parts":[[2026,3,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2025-071520","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,19]]},"article-number":"e2025071520"}}